For Bob, who is slender, fit and amazingly healthy for his age, his major symptom was incredible snoring, snoring that could lead to a lot of nocturnal pokes and jabs from me or send one of us out to the living room couch some nights and inspire me to buy great quantities of ear plugs.
For far too long, we simply lived with these symptoms, attributing them to yet another aspect of aging. I tried evening meditation and soothing sound machines in quest of a restful sleep. Bob tied a tennis ball to the back of his nightshirt to keep from rolling onto his back during sleep -- his prime snoring position. Countless others do the same -- simply accept sleep disturbances as part of aging or look for products to help the night time symptoms or daytime drowsiness.
Such symptoms, indeed, have spawned whole new product lines -- from "snore" rooms in new homes for the over-55 crowd to super-caffeinated beverages to over-the-ear devices that alert you when your head drops in sudden sleep when you're driving. And historically, there also has been a lot of joking about snoring and snorting during sleep.
But the cause of these symptoms is no laughing matter and something that neither snore rooms nor Jolt nor alert devices can fix: obstructive sleep apnea.
This sleep disorder is estimated to affect between 18 and 28 million Americans, the vast majority of whom don't realize they have it. With obstructive sleep apnea, soft tissue at the back of the throat sags during sleep and closes off the airway. The brain quickly alerts the sleeper, who wakes briefly, often many times an hour, gasping for air or who simply snores loudly through the night. As a result of these unremembered awakenings and oxygen deprivation, sometimes dipping below 65% of optimal blood oxygen levels, those with sleep apnea may wake up with headaches or feeling unrested or may experience daytime drowsiness.
While people of all ages and sizes can suffer from sleep apnea, those at particular risk are older, obese and more often male. However, older women, especially those who have been diagnosed with high blood pressure and whose Body Mass Index exceeds 30, may be at special risk as well.
Sleep apnea, and the disrupted sleep this condition causes, is a risk factor itself in a number of disorders including hypertension, a heightened risk for heart attack, stroke, Alzheimer's disease, type 2 diabetes, congestive heart failure and depression. Some people die in their sleep from apnea or apnea-related causes like heart attacks and strokes.
So how can you find out if you have sleep apnea and what can you do about it?
If you have any of the symptoms described above -- like snoring, awakening with a snort or gasp multiple times a night, morning headaches, daytime drowsiness -- talk with your doctor. He or she may refer you for a sleep study.
Sleep studies - which monitor brain and heart activity, breathing, arm and leg movement and oxygen levels throughout the night as you sleep -- are most often done at sleep disorder centers. Bob spent a night at a hospital-based center while I spent my restless night at an independent sleep center that was in a medical office building. In both cases, we had our own rooms with comfortable beds. The major difference: monitoring wires and cameras and occasional visits from technicians. These on-site studies can be expensive -- between $1,500-3,500 -- but in our cases, Medicare paid the entire amount.
If cost is a factor or if you can't imagine trying to sleep wired up away from home, there is a portable sleep study device called SleepQuest that a sleep specialist can provide for you at less cost ($400-650) that is also often covered by insurance.
Bob and I both were diagnosed with sleep apnea -- mine moderate, his severe. And we were both prescribed continuous positive airway pressure (CPAP) machines last March. Once again, Medicare covered the cost completely. Each machine was set to a prescribed air pressure to blow just the right amount of air necessary to keep our airways open and were fitted by a respiratory therapist who came to our home to make sure we understood how to use the devices.
Although the CPAP machines -- which can be fitted with a whole face or partial face mask or with "nose pillows" that fit directly into the nostrils -- can feel strange at first, persisting through any early discomfort is well worth the effort. We noticed an immediate improvement in sleep quality and feeling rested each morning. A cautionary note to others who may be getting CPAP machines through Medicare: there is a monitoring microchip in the device for the first 30 days to measure your compliance. You need to use the device most of the night, most nights, during that time in order to keep the device. Actually, this is a good motivation to stick with it: if you use it as directed for that first month, you won't want to be without it!
While CPAP machines are the most common ways of treating obstructive sleep apnea, some people find relief for their symptoms by using a specially fitted oral device made by a dentist to move your lower jaw forward, thus opening the throat. This is also quite often covered --in full or in part -- by insurance.
For those with milder sleep apnea who are not mouth breathers and who don't suffer from nasal allergies, there is a new device called Provent -- a small, disposable patch that fits over each nostril and uses your own breathing to create positive airway pressure to keep the throat open. These are available only by prescription and are not yet covered by insurance or Medicare.
I ran into a neighbor today -- thin, fit and in her 50's -- who told me that she had just been diagnosed with sleep apnea. She spent her first night last night on the CPAP and, to her great relief, did not have a panic attack and did wake up feeling more rested.
I'm still thankful that my husband sounded the alarm for me --and I for him. I'm grateful that our doctor referred us to sleep specialists. In my case, I complained about poor sleep quality and asked if sleeping pills might be the answer. He looked at me with great concern. "I want to test you for sleep apnea before prescribing anything," he said. "Because if you have sleep apnea and take a sleeping pill, there is a chance that you'll never wake up."
Thousands of people with undiagnosed sleep apnea die in their sleep every year -- from sleeping pills, from heart attacks or strokes.
So if, like ours, your sleep is far from peaceful these days, don't pop a pill or just chalk it up to another aspect of aging.
Check with your doctor now. It could save your life.